scholarly journals Interventional radiology training: where will technology take us?

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20190002
Author(s):  
Meghavi Mashar ◽  
Andrew Nanapragasam ◽  
Philip Haslam
Keyword(s):  
Interventional Radiology ◽  
Clinical Training ◽  
Three Dimensional ◽  
Evidence Base ◽  
Invasive Approach ◽  
Innovative Strategies ◽  
Novel Technologies ◽  
Radiology Service ◽  
Radiology Training ◽  
Recovery Times

Interventional radiology is a relatively young specialty, and it is undergoing a period of considerable growth. The benefits of a minimally invasive approach are clear, with smaller incisions, less pain, and faster recovery times being the principal benefits compared to surgical alternatives. Trainees need to acquire the technical skills and the clinical acumen to accurately deliver targeted treatment and safely follow up patients after the procedure. The need to maintain an efficient interventional radiology service whilst also giving sufficient time for trainee education is a challenge. In order to compensate for this, novel technologies like virtual reality (VR), augmented reality (AR), cadaveric simulation, and three-dimensional (3D) printing have been postulated as a means of supplementing training. In this article, we outline the main features of these innovative strategies and discuss the evidence base behind them. Benefits of these techniques beyond pure clinical training include the standardization of educational cases, access to training at any time, and less risk to patients. The main disadvantage is the large financial outlay required. Therefore, before widespread uptake can be recommended, further research is needed to confirm the educational benefit of these novel techniques, both in and of themselves and in comparison to existing clinical-based education.

scholarly journals A narrative overview of utilizing biomaterials to recapitulate the salient regenerative features of dental-derived mesenchymal stem cells

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Sevda Pouraghaei Sevari ◽  
Sahar Ansari ◽  
Alireza Moshaverinia
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Tissue Regeneration ◽  
3D Structure ◽  
Three Dimensional ◽  
Scientific Data ◽  
Clinical Practices ◽  
Human Teeth ◽  
Innovative Strategies ◽  
Local Recruitment

AbstractTissue engineering approaches have emerged recently to circumvent many limitations associated with current clinical practices. This elegant approach utilizes a natural/synthetic biomaterial with optimized physiomechanical properties to serve as a vehicle for delivery of exogenous stem cells and bioactive factors or induce local recruitment of endogenous cells for in situ tissue regeneration. Inspired by the natural microenvironment, biomaterials could act as a biomimetic three-dimensional (3D) structure to help the cells establish their natural interactions. Such a strategy should not only employ a biocompatible biomaterial to induce new tissue formation but also benefit from an easily accessible and abundant source of stem cells with potent tissue regenerative potential. The human teeth and oral cavity harbor various populations of mesenchymal stem cells (MSCs) with self-renewing and multilineage differentiation capabilities. In the current review article, we seek to highlight recent progress and future opportunities in dental MSC-mediated therapeutic strategies for tissue regeneration using two possible approaches, cell transplantation and cell homing. Altogether, this paper develops a general picture of current innovative strategies to employ dental-derived MSCs combined with biomaterials and bioactive factors for regenerating the lost or defective tissues and offers information regarding the available scientific data and possible applications.

Accuracy of Patient-Specific 3D Printed Drill Guides in the Placement of a Canine Coxofemoral Toggle Pin through a Minimally Invasive Approach

2020 ◽  
Author(s):  
Brett G. Darrow ◽  
Kyle A. Snowdon ◽  
Adrien Hespel
Keyword(s):  
Minimally Invasive ◽  
Three Dimensional ◽  
Bone Tunnel ◽  
Patient Specific ◽  
Exit Point ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Post Procedure ◽  
Drill Guide ◽  
Ct Data

Abstract Objective The aim of this study was to evaluate the accuracy of patient-specific three-dimensional printed drill guides (3D-PDG) for the placement of a coxofemoral toggle via a minimally invasive approach. Materials and Methods Pre-procedure computed tomography (CT) data of 19 canine cadaveric hips were used to design a cadaver-specific 3D-PDG that conformed to the proximal femur. Femoral and acetabular bone tunnels were drilled through the 3D-PDG, and a coxofemoral toggle pin was placed. The accuracy of tunnel placement was evaluated with post-procedure CT and gross dissection. Results Coxofemoral toggle pins were successfully placed in all dogs. Mean exit point translation at the fovea capitis was 2.5 mm (0.2–7.5) when comparing pre- and post-procedure CT scans. Gross dissection revealed the bone tunnel exited the fovea capitis inside (3/19), partially inside (12/19) and outside of (4/19) the ligament of the head of the femur. Placement of the bone tunnel through the acetabulum was inside (16/19), partially inside (1/19) and outside (2/19) of the acetabular fossa. Small 1 to 2 mm articular cartilage fragments were noted in 10 of 19 specimens. Clinical Significance Three-dimensional printed drill guide designed for coxofemoral toggle pin application is feasible. Errors are attributed to surgical execution and identification of the borders of the fovea capitis on CT data. Future studies should investigate modifications to 3D-PDG design and methods. Three-dimensional printed drill guide for coxofemoral toggle pin placement warrants consideration for use in select clinical cases of traumatic coxofemoral luxation.

Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England

Injury ◽  
2017 ◽  
Vol 48 (5) ◽  
pp. 1031-1034 ◽  
Author(s):  
Jane Hughes ◽  
Ashley Scrimshire ◽  
Laura Steinberg ◽  
Petros Yiannoullou ◽  
Katherine Newton ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Service Provision ◽  
Splenic Injury ◽  
Radiology Service ◽  
Trauma Networks

scholarly journals A new subclass of exoribonuclease resistant RNA found in multiple Flaviviridae genera

2020 ◽  
Author(s):  
Matthew J. Szucs ◽  
Parker J. Nichols ◽  
Rachel A. Jones ◽  
Quentin Vicens ◽  
Jeffrey S. Kieft
Keyword(s):  
Rna Structure ◽  
Three Dimensional ◽  
Viral Rna ◽  
Human Pathogens ◽  
Virus Family ◽  
Innovative Strategies ◽  
Virus Rna ◽  
High Resolution Structure ◽  
Cellular Machinery ◽  
Rna Maturation

ABSTRACTViruses have developed innovative strategies to exploit the cellular machinery and overcome the host antiviral defenses, often using specifically structured RNA elements. Examples are found in flaviviruses; during flaviviral infection, pathogenic subgenomic flaviviral RNAs (sfRNAs) accumulate in the cell. These sfRNAs are formed when a host cell 5’ to 3’ exoribonuclease degrades the viral genomic RNA but is blocked by an exoribonuclease resistant RNA structure (xrRNA) located in the viral genome’s 3’untranslated region (UTR). Although known to exist in several Flaviviridae genera the full distribution and diversity of xRNAs in this virus family was unknown. Using the recent high-resolution structure of an xrRNA from the divergent flavivirus Tamana bat virus (TABV) as a reference, we used bioinformatic searches to identify xrRNA in the Pegivirus, Pestivirus, and Hepacivirus genera. We biochemically and structurally characterized several examples, determining that they are genuine xrRNAs with a conserved fold. These new xrRNAs look superficially similar to the previously described xrRNAs but possess structural differences making them distinct from previous classes of xrRNAs. Our findings thus require adjustments of previous xrRNA classification schemes and expand on the previously known distribution of the xrRNA in Flaviviridae, indicating their widespread distribution and illustrating their importance.IMPORTANCEThe Flaviviridae comprise one of the largest families of positive sense single stranded (+ssRNA) and it is divided into the Flavivirus, Pestivirus, Pegivirus, and Hepacivirus genera. The genus Flavivirus contains many medically relevant viruses such as Zika Virus, Dengue Virus, and Powassan Virus. In these, a part of the virus’s RNA twists up into a very special three-dimensional shape called an xrRNA that blocks the ability of the cell to “chew up” the viral RNA. Hence, part of the virus’ RNA remains intact, and this protected part is important for viral infection. This was known to occur in Flaviviruses but whether it existed in the other members of the family was not known. In this study, we not only identified a new subclass of xrRNA found in Flavivirus but also in the remaining three genera. The fact that this process of viral RNA maturation exists throughout the entire Flaviviridae family makes it clear that this is an important but underappreciated part of the infection strategy of these diverse human pathogens.

scholarly journals Discovering new 3D bioprinting applications: Analyzing the case of optical tissue phantoms

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Marisela Rodriguez-Salvador
Keyword(s):  
Optical Properties ◽  
3D Printing ◽  
Clinical Training ◽  
Three Dimensional ◽  
Biological Tissues ◽  
3D Bioprinting ◽  
Technology Intelligence ◽  
Biomedical Device ◽  
Tissue Phantoms ◽  
Scientific Papers

Optical tissue phantoms enable to mimic the optical properties of biological tissues for biomedical device calibration, new equipment validation, and clinical training for the detection, and treatment of diseases. Unfortunately, current methods for their development present some problems, such as a lack of repeatability in their optical properties. Where the use of three-dimensional (3D) printing or 3D bioprinting could address these issues. This paper aims to evaluate the use of this technology in the development of optical tissue phantoms. A competitive technology intelligence methodology was applied by analyzing Scopus, Web of Science, and patents from January 1, 2000, to July 31, 2018. The main trends regarding methods, materials, and uses, as well as predominant countries, institutions, and journals, were determined. The results revealed that, while 3D printing is already employed (in total, 108 scientific papers and 18 patent families were identified), 3D bioprinting is not yet applied for optical tissue phantoms. Nevertheless, it is expected to have significant growth. This research gives biomedical scientists a new window of opportunity for exploring the use of 3D bioprinting in a new area that may support testing of new equipment and development of techniques for the diagnosis and treatment of diseases.

scholarly journals Curriculum mapping for Focused Acute Medicine Ultrasound (FAMUS)

2018 ◽  
Vol 17 (3) ◽  
pp. 168-168
Author(s):  
Karim Fouad Alber ◽  
◽  
Martin Dachsel ◽  
Alastair Gilmore ◽  
Philip Lawrenson ◽  
...  
Keyword(s):  
Focused Ultrasound ◽  
Point Of Care ◽  
Evidence Base ◽  
Response To Treatment ◽  
Point Of Care Ultrasound ◽  
Curriculum Mapping ◽  
Acute Medicine ◽  
Portable Ultrasound ◽  
Sonographic Assessment ◽  
Radiology Training

Dear sir/madam, Point of care ultrasound (POCUS) in the hands of the non-radiologist has seen a steady growth in popularity amongst emergency, intensive care and acute medical physicians. Increased accessibility to portable, purpose-built ultrasound machines has meant that clinicians often have access to a safe and non-invasive tool to enhance their management of the unwell. Focused Acute Medicine Ultrasound (FAMUS) is the point of care ultrasound curriculum created to aid the management of the acutely unwell adult patient. Following a survey of trainees and consultants, it was apparent that there was a strong desire for Acute Medics to be able to use point of care ultrasound to aid their clinical diagnostic skills. The FAMUS committee was set up to develop competencies using the evidence base available. FAMUS stands in contrast to traditional radiology training modules, which focus on carrying out comprehensive assessments of anatomy and pathology. Instead, FAMUS delivers a syndrome-based sonographic assessment with the aim of ruling out gross pathology and interrogating underlying physiology. It serves as a useful adjunct to history and clinical examination by way of providing key information quickly and non-invasively. Furthermore, it provides a feasible way to monitor response to treatment or progression of disease and thereby providing useful dynamic information quickly and safely. The accreditation in FAMUS involves the sonographic assessment of three systems: lung, abdomen and the deep veins of the lower-limb. Accrediting in each one involves theoretical learning, a formal course attendance and achieving a set number of supervised and mentored scans. As well as technical skills, the candidate must demonstrate competence in recognising key pathology and drawing appropriate conclusions about each scan, including when to refer for departmental imaging. FAMUS was met with enthusiasm by trainees and consultants in acute medicine, and its popularity rises as more courses are becoming available for accreditation paired with increasing access to portable ultrasound units. It is envisioned that this will continue to grow and formal ‘train the trainer’ courses have been held in order to increase the pool of available supervisors. Currently, FAMUS is endorsed by the Society for Acute Medicine and recognised by the AIM training committee as a specialist skill that can be undertaken during specialist training. It has been proposed that FAMUS should be considered for integration into the acute internal medicine (AIM) curriculum, which will be re-written for 2022 in line with the GMC’s revised standards for curriculum and assessment. Thus we present in this letter, a curriculum mapping exercise that utilises a ‘knowledge, skills, behaviours’ framework in order to be considered for the AIM curriculum rewrite. We believe this will provide a standard and framework to integrate focused ultrasound in AIM training programmes with the aim of ultimately incorporating FAMUS as a core skill for all AIM trainees.

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